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Ellen Starr and Mesfin

ana in Ethiopia

Cleophace Mukeba is a self-confessed “mother’s boy” and feminist. Growing up in the South Kivu province of the Democratic Republic of the Congo, he helped his mother with household chores. “I wanted her to let me do [them] so that she can rest,” Mukeba said. Today, the 49-year-old Vermonter lives in Burlington and works as an interpreter. He is also the founder and executive director of the nonprofit Vermont Ibutwa Initiative (VIBI). Mukeba established the organization in 2011 in memory of his mother, who was killed during civil unrest months before the First Congo War started in 1996. He is a New American looking to make a difference in his old home. Ibutwa means “renaissance” in Lega, one of the dialects spoken in South Kivu. The nonprofit g es a new lease on life to Congolese women and girls who were victims of sexual violence during the country’s protracted civil war.

Cleophace Mukeba in the Congo


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“Women in Congo are living in a maledominated culture,” Mukeba said. “Nobody thinks that women deserve a second chance.” VIBI operates in Uvira and Kamanyola villages. It helps 33 families, including 110 children. Women head most of the households. Victims receive medical treatment and financial help to start small businesses. The nonprofit also pays for the children’s schooling and uniforms. VIBI receives most of its funding from churches and private donors in Vermont. “One hundred dollars can send a child to school for a year,” Mukeba said. The nonprofit employs three in-country Congolese. Kangele Bin Kazembe is the field coordinato . Pelagie Missasa runs the sustainable livelihood program, helping the women plan their budgets and manage their profits. Emmanuel Lwitela is the director of Ibutwa Clinic in Uvira. Since its inception, Mukeba’s nonprofit has faced challenges. Its medical supervisor died during childbirth last year. One of the women in Kamanyola was so successful in her pig-raising project, he noted, that a jealous villager poisoned her sow. “It’s tough because it consumes most of my time,” Mukeba said of the work. But he remains undeterred because he’s seen how women and children have been able to turn their lives around. “I’m trying to do what I can do for them,” Mukeba said. “We’ll get to where we’re supposed to be.”


By then, their chances of getting proper treatment for the late-stage disease are poor — hence the high fatality rate: Nearly a quarter-million women in low-income countries die of cervical cancer every year, compared to 35,514 everywhere else, according to the WHO’s ICO Information Centre on E LL E N S TAR R HPV and Cancer. Fote urged his younger friend to start a screening clinic. “Doc, I’m a coffee guy,” Cox said he replied. Fote told him: “Well, you have contacts.” GMCR and Ben & Jerry’s were among the first to front funds for Grounds for Health when it started in 1996. Spanish-speaking volunteer clinicians from the U.S. provided training to local health professionals and read the screening tests. About four years in, Cox hit a wall. We’ve either got to expand and hire someone full time, or we ought to close shop, he remembered thinking in 1999, after he’d left GMCR and started his own business, Coffee Enterprises. Cox went with the former option, and Grounds for Health hired its first executive director. Its third, Guy Stallworthy, joined the nonprofit in mid2014, bringing more than 30 years of experience in health and development. Today, the organization operates in Ethiopia, Kenya and Peru. The group has worked in Mexico, Nicaragua and Tanzania, too. It has screened more than 70,000 women and treated about 5,000 of them. It has also trained nearly 460 health care providers.

We’re not done until every woman in our target age group has actually been screened.



Coffee workers

Stallworthy said it makes financial sense to keep the number of U.S.-based staff small — it’s currently five — and to train on-site health providers to do the screenings. “It’s all about having greater impact and building capacity,” said Stallworthy. He noted that projected expenditures for this fiscal year are approximately $700,000. Starr, who is the project’s clinical director, agreed with his assessment. “This is not missionary work. This is not the great white hope coming into Africa and saying, ‘Here, let us provide you services,’” she said. “The [local health] ministries need to be on board, both philosophically and financially.” Grounds for Health now focuses on sub-Saharan Africa because the need there is great. And it’s able to start “from more of a clean slate,” said Starr. The African countries where it’s working either don’t have cervical cancer prevention programs or have nascent ones that align closely with the nonprofit’s. Primarily serving women ages 30 to 49, the group uses a visual inspection program. A health care provider rests a cotton swab soaked in vinegar on the cervix for about two minutes. He or she then removes it and evaluates the cervix, looking for white spots that have been made visible by the vinegar. Many U.S. health care providers use the same simple technique. If a woman tests positive, she can be treated with cryotherapy. This involves freezing potentially precancerous cells with carbon dioxide. Both the screening and cryotherapy are done on the same day, so the woman is tested and treated in one visit. That makes it more convenient for the cooperatives, which are “wonderful champions” of the work that the nonprofit does and often provide transportation for the patients, Starr noted. “They want their workers to stay healthy,” she pointed out. At Stallworthy’s urging, the organization is looking to move into other agricultural industries such as flowers, cocoa and tea, as well as garment factories. Workers in those industries are usually women with limited access to health care, he noted. “Living in a globalized world, we’re all benefiting from access to products at a cheap price,” said Stallworthy. “It is incumbent on us to realize the inequities that lie behind them as consumers and companies.” In this case, that’s in the realm of women’s health. “We’re not done until every woman in our target age group has actually been screened,” Starr promised. Innovation is also a priority for Grounds for Health. Since spring 2015, the organization has been using a handheld cervicography device developed by Tel Avivbased startup MobileODT. In-country coordinators take pictures of a cervix with the device and upload the images to a cloud system. From her office in Williston, Starr reviews the images and gives her assessment to colleagues in the field. But Wi-Fi connectivity  in subSaharan Africa can be unreliable, so it doesn’t always work. Today Cox, 67, lives in Shelburne and sits on the nonprofit’s board of directors. His main job, he said, is to support the organization by leveraging his contacts in the coffee industry, which continues to be its main source of funding. Grounds for Health has since received some aid from the U.S. government and gets corporate support, too. Looking back, Cox is amazed by how much the organization has achieved. “I had a little piece in doing the right thing, and it feels pretty good,” he said.

Seven Days, November 23, 2016  

Three Vermont Nonprofits That Think Locally, Work Globally; Can a Scandal-Plagued Hotel Save Burke Mountain?; The Read on Sen. Bernie Sander...

Seven Days, November 23, 2016  

Three Vermont Nonprofits That Think Locally, Work Globally; Can a Scandal-Plagued Hotel Save Burke Mountain?; The Read on Sen. Bernie Sander...